Tricuspid valve repair using tension

Abstract

A method is provided for repairing the tricuspid valve of a patient using tension. A radially-expandable stent is implanted in a coronary sinus of the patient. A tissue anchor is implanted in tissue in the vicinity of the tricuspid valve. The tricuspid valve is repaired by applying tension between the radially-expandable stent and the tissue anchor using a flexible longitudinal member that connects the radially-expandable stent and the tissue anchor.

The invention claimed is: 
     
       1. A method for repairing the tricuspid valve of a patient using tension, the method comprising:
 implanting a radially-expandable stent in a coronary sinus of the patient; 
 implanting exactly one tissue anchor in tissue in the vicinity of the tricuspid valve at a site selected from the group consisting of: a site on the annulus of the tricuspid valve, and a site in a portion of tissue of a wall defining the right atrium; and 
 repairing the tricuspid valve by applying tension between the radially-expandable stent and the exactly one tissue anchor using a flexible longitudinal member that (a) connects the radially-expandable stent and the tissue anchor and (b) crosses over a portion of the tricuspid valve. 
 
     
     
       2. The method according to  claim 1 , wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor on the annulus of the tricuspid valve. 
     
     
       3. The method according to  claim 2 , wherein applying the tension comprises altering the geometry of the annulus of the tricuspid valve. 
     
     
       4. The method according to  claim 1 , wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor in a portion of tissue of a wall defining the right atrium. 
     
     
       5. The method according to  claim 4 , wherein applying the tension comprises altering the geometry of the wall of the right atrium. 
     
     
       6. The method according to  claim 1 , wherein applying the tension comprises drawing at least first and second leaflets of the tricuspid valve toward each other. 
     
     
       7. The method according to  claim 1 , wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor at an implantation site selected from the group consisting of:
 an anteroposterior commissure of the tricuspid valve, and 
 a site between (a) the middle of the junction between the annulus and an anterior leaflet of the tricuspid valve and (b) the middle of the junction between the annulus and the posterior leaflet of the tricuspid valve. 
 
     
     
       8. The method according to  claim 1 , wherein applying the tension comprises adjusting a distance between the radially-expandable stent and the exactly one tissue anchor, and monitoring a parameter indicative of regurgitation of the tricuspid valve while adjusting the distance. 
     
     
       9. The method according to  claim 1 , wherein applying the tension comprises cinching the tricuspid valve. 
     
     
       10. The method according to  claim 9 , wherein cinching the tricuspid valve comprises causing bicuspidization of the tricuspid valve. 
     
     
       11. The method according to  claim 1 , wherein implanting the radially-expandable stent and the exactly one tissue anchor comprises implanting the radially-expandable stent and the exactly one tissue anchor on generally opposite sides of the tricuspid valve. 
     
     
       12. The method according to  claim 1 , wherein implanting the exactly one tissue anchor comprises rotating the exactly one tissue anchor.